No, she's not the heroine of the latest sci-fi flick or vampire TV series. She's an average 53-year-old woman whose heart, just a year and a half ago, was operating at only a quarter of its normal capacity.

Enter a cutting-edge new medical intervention, a left ventricular assist device. Most people have never heard of an LVAD--unless they happened to be paying close attention last year when former vice president Dick Cheney, a survivor of five heart attacks, had one installed. Scientists have been working on the technology (basically a scaled-down version of a jet engine) for several decades, but it wasn't until the mid-1990s that there was a model that could be implanted inside a patient's chest cavity, and it wasn't until 2005 that the device was tailored to be small enough to fit the average woman.

The LVAD was originally intended as a stopgap measure to keep patients alive while they waited for a heart transplant to become available. The 2-year survival rate for people with end-stage heart failure had been 8%; after the LVAD first became available, the rate jumped to 23%. And although the new, petite model, the HeartMate II, has been FDA approved for only 3 years, it's already been okayed as a "destination therapy," meaning it can be used in patients who aren't good transplant candidates. The real hope is that one day LVADs may replace heart transplants altogether. In the meantime, they're saving women's lives.

A Broken Heart

In her early 20s, Thomas became unexpectedly ill, and doctors discovered damage to her cardiac muscle and told her she had congestive heart failure. A normal heart pumps out between 55 and 70% of its blood with each beat; heart failure may be diagnosed when that "ejection fraction," as it's called, drops below 45%, and Thomas's was at about 20%. Once she'd recovered, she managed to keep her condition relatively stable under the care of various cardiologists, who put her on meds, including the beta-blocker carvedilol and digoxin, to regulate her heart function. For years, these proved effective in strengthening her heart muscle.

All seemed well until she reached age 40, when her condition deteriorated and her heart function again dropped. Even getting a pacemaker to control her irregular heartbeat didn't halt the progress of the disease. Then, last summer, her condition became critical. She felt exhausted and weak, coughed constantly due to fluid in her lungs, and had trouble sleeping.

"She was making gurgling noises at night," recalls her husband, Paul, a manager for CVS. She couldn't even climb the three steps to enter her house without help.

His resources exhausted, Thomas's cardiologist recommended that she try Washington Hospital Center, one of the country's top cardio-care facilities, located in nearby Washington, DC. Before she'd even made an appointment, Thomas woke up one August morning to find she could barely breathe. "I asked my husband to drive me to the hospital, but I was terrified the doctors would say, 'Joyce, there's nothing more we can do for you,' " she recalls.

As scared as they were, the couple passed the closest hospitals and drove 45 minutes to Washington Hospital Center. It's lucky they did. The doctors there determined that Thomas was in dire shape, but not eligible for an immediate heart transplant. However, this cardiac center offered another option, one that only two hospitals in the area provided: The facility's specially trained surgeons could attach a 3-inch LVAD to Thomas's heart to pump her blood for her. Thomas was so ill that the operation--though less strenuous than a transplant--wouldn't be easy, nor would the substantial lifestyle changes she and her family and friends would have to make. But it gave her a second chance. And she'd be alive.

Thomas was in such critical condition that the doctors told her she had to decide right away, before her heart deteriorated further. Her ejection fraction was down to a mere 15%: There was no contest. Two days later, on a Thursday, she had the LVAD implantation surgery. The following Monday she was already sitting up in the intensive care unit. "I quickly started to feel so good," she says. The first time she went for a walk outside her hospital room, she remembers, "My doctors were standing out in the hallway, and they all started clapping."

Her Miraculous Recovery

In November, 3 months after the life-saving surgery, Thomas was back at home and at work--and healthier than ever. "I feel great, better than I have in years," she says. "I'm full of energy, and I can work around the house and go for walks with my husband again."

Even though only 15,000 people so far have received an LVAD--and only approximately 7,000 have the new, smaller HeartMate II--the heart pump is undoubtedly a game changer.

"We're talking about a tremendous improvement in survival rates," says Samer Najjar, MD, medical director of heart failure, heart transplantation, and mechanical circulatory support programs at Washington Hospital Center. Earlier this year, a study showed an 85% 1-year survival rate for LVAD patients awaiting transplant, which rivals the 88% 1-year rate for those receiving transplants--until now, the gold standard for heart failure treatments. "LVADs have already reduced the need for heart transplantation, and I have no doubt that a total artificial heart will eventually be perfected," says Steven E. Nissen, MD, chairman of the department of cardiovascular medicine at the Cleveland Clinic.

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A Day In The Life Of An LVAD Patient

Living with an LVAD is not for the faint of heart: It takes constant commitment from the patient and a support team of friends and family.

The pump's power cord exits the patient's body through an open incision, which must be kept clean, dry, and bandaged at all times to prevent infection. Since Joyce Thomas's husband wasn't able to take time off from work to attend the extensive training sessions, her sister, Debby, who lives nearby, cleans the incision and changes the dressing twice a week. The process takes about 45 minutes.

What's more, water is kryptonite to the apparatus, so swimming and strolling in the rain are out. Thomas has a waterproof bag to protect her batteries in the shower, but she finds it too cumbersome, so instead, she fills the tub, sits on the edge, and gives herself a thorough sponge bath.

But the most nerve-racking reality is the 12-hour-max life span of her LVAD batteries--without which Thomas would die within minutes. The power cord coming out of her abdomen connects to a controller that attaches to the battery packs, which she carries in a fanny pack or shoulder bag. The importance of carrying a spare set of batteries at all times is drilled into LVAD patients: Their lives depend on it.

During the day, just carrying around the 6-pound battery pack (plus the spare) is a substantial burden--so Thomas gets help. "If Paul and I are going out, he carries the pack for me," Thomas says. "When I'm at work and we go to lunch, my friends may offer to help. But I enjoy being independent."

At night, Thomas has to sleep with her power cord connected to a main unit in her bedroom that plugs into a regular wall socket. "If I want to go to the kitchen, I have to put the batteries back in," she says, but a 20-foot-long cord allows her enough mobility to get as far as the bathroom without batteries. "And in terms of being intimate, it hasn't affected us at all," she adds.

Despite the challenges, all that cooperation has heartwarming bonuses: Thomas says her marriage is stronger than ever. "It's brought us closer together."

The LVAD's original manufacturer, Thoratec, estimates that between 50,000 and 100,000 heart failure patients a year could benefit from the device. But only about 135 of the 5,000-some hospitals in this country have invested in the extensive training, equipment, and personnel necessary to implant heart pumps--whether for patients awaiting heart transplants or as destination therapy--and provide the follow-up care needed.

Because LVAD procedures are concentrated in such a small handful of hospitals, many doctors--even cardiac specialists--are unaware that this treatment option exists.

"The task for us is really to educate cardiologists," Dr. Najjar says. "So many more patients could benefit from this technology than now do."

Thomas is living proof of what a difference the device can make. Accepting the challenges that come with an LVAD is easy because she simply feels so much healthier. Smiling as she pats the battery pack she must keep with her at all times, she says, "As for carrying this thing around? It's just like a purse. Except it's keeping me alive."

What Makes A Heart Pump Tick

A healthy human heart pumps about 2,000 gallons of blood through the body daily, delivering oxygen and nutrients to organs and tissues. But if damaged or weakened by heart disease or a heart attack, it can't pump with the force required to get the organs what they need. That's what's meant by the term "heart failure," which affects more than 5 million Americans (approximately 2.6 million of them women), with about half a million more diagnosed every year. It results in shortness of breath, fatigue, chest congestion, swelling of the legs, and kidney problems. Ultimately, heart failure can be fatal.

That's where the LVAD comes in. The pump is about the size of a D battery, with two flexible tubes, one of which attaches to the aorta, the other to the left ventricle. Once implanted, the pump takes over the function of the left ventricle--the largest and hardest-working chamber of the heart--pushing blood out through the aorta to the rest of the body. The device is powered by special batteries that are connected to a controller, which attaches to a power cord that extends from the LVAD through a permanent incision in the patient's abdomen.

Unlike the heart you were born with, however, the LVAD motor moves blood continuously, not with a pumping rhythm. That's why most patients, like Joyce Thomas, have no pulse. As a result, they have to wear medical alert tags at all times--so if they're knocked unconscious in an accident, for example, emergency workers won't assume that they're dead.

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What Happens When Your Heart Won't Ever Stop?

LVAD technology is still so new that no one's caught up yet with the ethical and legal questions it presents. If a heart pump patient has a stroke or other condition that causes multiple organ failure or brain damage, the LVAD keeps on working, meaning that--legally speaking--the patient doesn't die. Should the pump be disconnected? And if so, when--and who makes the decision?

Ideally, the answer is: the patient herself.

"It's crucial to begin to discuss some of these contingencies with the patient before they happen," says Lynne Warner Stevenson, MD, a professor of cardiovascular medicine at Harvard Medical School and director of the cardiomyopathy and heart failure program at Brigham and Women's Hospital in Boston. A recent Mayo Clinic study of 14 patients whose heart pumps were disconnected when the patients were in dire condition found that even when they had left end-of-life instructions, none of them mentioned their LVADs. In 12 of these cases, the families and medical staff had to make the harrowing choice to disconnect the LVAD. The other two patients were still able to ask to be allowed to die.

The study's authors concluded that "carrying out such requests is permissible" because death results from the underlying heart disease. The idea is that the LVAD should be treated like any other life-extending apparatus, such as a breathing tube. But that may offer scant comfort for families faced with such a painful choice. To spare them guilt and uncertainty, Dr. Stevenson asks her patients to make end-of-life decisions before the LVAD is implanted.